检体诊断学：13 心脏的检查.pptVIP

* Factors of heart itself（心脏本身因素） ★ Enlargement of right ventricle（右室增大）-- pulmonary heart disease（肺源性心脏病） ◆ Slight enlargement -- no obvious change in area of relative dullness（轻度增大时心脏相对浊音界无明显改变）； ◆ Prominent enlargement – relative dullness enlarged both to left and right but not downwards（显著增大时心脏相对浊音界向左右增大，但向左不向下增大）。 * Left atrium and pulmonary dilatation Both the left artrium and pulmonary artery enlarged, the pulmonary artery will be exaggerated扩大 to leftward. The cardiac silhoutte is like a pear and called mitral heart, it is frequently seen in mitral valve stenosis. Aortic dilation, aneurysm of aorta, pericardial effusion, all those diseases may cause the base border of heart enlargement, so that the base border of the heart will be widened. * The purpose of auscultation of the heart is to find the normal and abnormal sounds of the heart. It plays a very important role in the diagnosis of heart disease. It is a very interesting thing to master the auscultation, but it is difficult. Definition（定义）： When heart valves open and close，they make sounds which can be transmitted to body surface. The locations where examiners can　hear the sounds most clearly and easily are called auscultatory valve areas.(心脏各瓣膜开放与关闭时所产生的声音传导到体表最易听清的部位称心脏瓣膜听诊区)。 * Sounds produced by each valves of the heart may propagate to different area at the pericardial area following the blood stream. At this area, one can hear the sound clearest in auscultation. It is called “auscultatory valve area”. The auscultatory valve area does not correspond with the anatomic location of the valve themselves. Definition（定义）of the Auscultatory Valve Area(瓣膜听诊区) ： When heart valves open and close，they make sounds which can be transmitted to body surface. The locations where examiners can hear the sounds most clearly and easily are called auscultatory valve areas.(心脏各瓣膜开放与关闭时所产生的声音传导到体表最易听清的部位称心脏瓣膜听诊区)。 * l. Mitral valve area: it is at the apex, in the fifth left intercostal space, medial to the